Provider Demographics
NPI:1093873168
Name:EAR, NOSE & THROAT SPECIALISTS OF TULSA, LLP
Entity Type:Organization
Organization Name:EAR, NOSE & THROAT SPECIALISTS OF TULSA, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REP
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-388-9749
Mailing Address - Street 1:6802 S OLYMPIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-1826
Mailing Address - Country:US
Mailing Address - Phone:918-388-9090
Mailing Address - Fax:918-388-9093
Practice Address - Street 1:6802 S OLYMPIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74132-1826
Practice Address - Country:US
Practice Address - Phone:918-388-9090
Practice Address - Fax:918-388-9093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19093207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1972593622OtherEHR INCENTIVE PROGRAM
OK1245229657OtherEHR INCENTIVE PROGRAM
OK1154310555OtherEHR INCENTIVE PROGRAM
OK1790782506OtherEHR INCENTIVE PROGRAM
OK1457340507OtherEHR INCENTIVE PROGRAM
OK1225027394OtherEHR INCENTIVE PROGRAM
OK1245229657OtherEHR INCENTIVE PROGRAM
OK1154310555OtherEHR INCENTIVE PROGRAM
OK1972593622OtherEHR INCENTIVE PROGRAM